CAMHP
Center for Advanced Mental Health Practice
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No Surprises Act

Right to Receive a Good Faith Estimate of Expected Charges

Effective and last updated: August 12, 2026

If you do not have health insurance or do not plan to use insurance to pay for your care, you have the right to receive a written Good Faith Estimate explaining how much your health care is expected to cost.

Who may receive an estimate

A Good Faith Estimate is available when you are uninsured or when you have insurance but choose not to use it for the scheduled item or service. Tell CAMHP when scheduling if you will not use insurance. You may also request an estimate before deciding whether to schedule care.

When you should receive it

What the estimate means

Expected charges

The estimate will describe the reasonably expected charges for the scheduled item or service based on the information known when the estimate is prepared.

Not a bill or guarantee

A Good Faith Estimate is not a bill and does not require you to receive care. Actual charges may differ if your needs or treatment plan change or if additional services become necessary.

Ask CAMHP whether separately scheduled or recommended services from other providers may result in additional charges. A CAMHP estimate covers the providers and services identified in that estimate.

Save and compare your estimate

Keep a paper or electronic copy of your Good Faith Estimate. When you receive a bill, compare the charges from each provider or facility with the amount that provider or facility estimated.

If your bill is at least $400 higher

If the billed charges from a provider or facility are at least $400 more than the amount listed for that provider or facility on your Good Faith Estimate, you may be eligible to use the federal patient-provider dispute resolution process. In general, a dispute must be started within 120 calendar days of the date on the initial bill.

You may first contact CAMHP to ask whether the bill can be updated, to negotiate the bill, or to ask about available financial arrangements. Contacting CAMHP does not prevent you from pursuing your federal rights, but do not delay beyond an applicable deadline.

For official instructions, visit the Centers for Medicare & Medicaid Services:

Request a CAMHP Good Faith Estimate

Contact CAMHP and say that you are uninsured or do not intend to use insurance and would like a written Good Faith Estimate.

Mississippi: 380-291-2120
Ohio: (216) 501-1730
Email: camhp@camhp.us

Please do not include diagnoses, medication information, or other sensitive medical details in ordinary email. CAMHP may contact you through a more appropriate method to gather the information needed for the estimate.